Thursday, October 6, 2011

Preventing and Treating Post-Partum Depression: What Can I Do?

If you are experiencing sadness or anxiety at a time when you thought you'd be filled with elation~you're not alone.
Many women experience some form of the "Baby-Blues" or "Post-Partum Depression" (PPD) after the birth of their baby. This should not come as a surprise, given that many of the triggers for depression are inherent in pregnancy, childbirth, and post-partum. In particular, they are a time of transition and relationship changes, sometimes conflict, loss, grief or disappointment, and certainly hormonal and sleeping pattern changes. Knowing this, how can you prepare for or decrease your likelihood of experiencing some form of Baby Blues or PPD- or recognize and find help for PPD?

First of all, identify your own risk factors. Are there things in your life that you can address now- before or during your pregnancy- that will reduce your risk. Do you have some personal issues that have been left unresolved? Are there steps you can take to make your life more balanced? Do you use negative thought processes that might magnify problems rather than resolving them? For example, several self-treatment cognitive therapies  include: 1) changing all or nothing perceptions into incremental or continuum thinking; 2) creating a blame-pie to determine realistically how responsible you or someone else is for something rather than attributing all of the blame to one person; 3) replacing "should" statements with "it would be nice if...but the reality is...therefore my most effective response could be.."; and 4) trying to create a better filter to view the world through- for example looking around for things that you are grateful for or that are going well in your life (creating a gratitude journal) so that you are focusing on positive things in your life rather than focusing on what is wrong.

Second, prepare for life after the baby is born. Discuss with your family what kinds of arrangements and changes will likely need to take place. Mother's under stress, who lack adequate sleep, or are experiencing health challenges after the birth are more likely to experience some form of depression or anxiety.
  • Help: Arrange for extra help with daily responsibilities (meals, cleaning, laundry, childcare for older children). Rearrange your expectations so that life after your baby is born becomes a sacred cocoon for you both to bond and recover in (social engagements can wait). Minimize stresses and maximize recovery and adjustment time.
  • Sleep: Sleep when your baby sleeps (newborn babies sleep an average of 15-19 hours in a 24 hour period-if you sleep at the same times, you will get enough sleep). 
  • Food: Keep nourishing and healthy food and drinks with you at all times (especially beside your bed at night). Many scientists believe that depression is a nutrition-deficiency illness. Make sure you are getting enough vitamin B's (Vitamin B's are all water soluble except vitamin B-12- this means they don't last long in your body and must be replaced regularly) and D (spend some time in the sunshine), and DHA (found in eggs, fish, and fish oil supplements). In general, food sources are more effective than supplements. Also, consider drinking Nettle Leaf or Dandelion Tea which are both high in vitamins and minerals.
  • Breastfeed: Seek help immediately for any concerns or challenges that you have with breastfeeding-you will get more rest if you are both eating well, and you will be more comfortable physically if you can prevent infections or other discomforts. Mothers who breastfeed are less likely to experience PPD but mothers who experience problems with breastfeeding (mastitis, inverted nipples etc.) are more likely to experience PPD.
  • Bond: Create rituals and special moments throughout your day that promote bonding: sing lullabies or read to your baby, snuggle, caress, enjoy skin-to-skin contact as much as possible, think of yourself and your baby as a team (this includes Dads!). The more bonding that takes place between baby, mother and father, the more your body will create positive bonding hormones (like prolactin, oxcytocin, and endorphins) that trigger feelings of well being, love, and protective and caring instincts. These will make it so much easier to sacrifice personal time, and fend of the blues.
  • Connect: Eventually- when you are feeling up to it- connect with other mothers. Sharing, learning, and bonding with other mothers who are going through similar experiences will be nourishing and supportive for both you. 
  • Tests: Discuss your feelings with your doctor. There may be medical reasons for your PPD such as hypothyroidism, which is easily tested and treated.  
There is much you can do to help create a more peaceful and harmonious post-partum recovery period. However, some things you have very little control over: the rapid decrease in progesterone and estrogen immediately after the birth is a dramatic hormonal change that all women must cope with, possible changes in your thyroid, a challenging birth experience, loss or grief, or genetic predispositions. Even if you try to prepare for every eventuality, you may still find yourself experiencing feelings of sadness, loss, disorientation, anger, or frustration that interfere with everyday life for an extended time. If this is the case, you may be suffering from PPD, and you should seek help immediately.

Some helpful local resources aside from family, friends, or your primary care provider (Kuwait) include: 

New Mother Groups, like the ones organized by Expat Mums in Kuwait (requirements: English speaking expat) or the British Ladies Society

Online forums, such as those hosted by Expat Mums in Kuwait, or Post Partum Progress (the most widely read blog on PPD in the USA- members receive daily emails and participate in group discussions), or Ask An Expert through LAMAZE (Henci Goer- author of The Thinking Woman's Guide to Childbirth- answers questions through an online forum.)

Therapy, including one-on-one counseling with a clinical psychologist (Altaf +965-9963-1239) or NLP Life Coach/Hypnotherapist (Naseera Hoorzook +965-9094-3454

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